title: C-reactive protein elevation and rapid angiographic progression of nonculprit lesion in patients with non-ST-segment elevation acute coronary syndrome.
abstract: BACKGROUND
  In non-ST-segment elevation acute coronary syndromes (NSTE-ACS), the relation of the level of high-sensitivity C-reactive protein (CRP) to the progression of atherosclerosis remains unclear.
  
  
  RESULTS
  The study group comprised 153 patients with NSTE-ACS who underwent percutaneous coronary interventions (PCI) and follow-up (mean interval, 7 months) coronary angiography. Rapid progression was defined as > or =10% diameter reduction of a preexisting stenosis > or =50%, > or =30% diameter reduction of a stenosis <50%, development of a new stenosis > or =30% in a previously normal segment, or progression of any stenosis to total occlusion. Progressors had higher CRP levels on admission and at 48 h after PCI, a higher level of low-density lipoprotein cholesterol at follow-up, a higher rate of multiple complex lesions, and a lower frequency of statin use at follow-up than nonprogressors. Multivariate analysis showed that admission CRP elevation (CRP level on admission > or =0.166 mg/dl, median value; odds ratio (OR) 2.92, p=0.010), post-PCI CRP elevation (CRP level 48 h after PCI > or =1.586 mg/dl, median value; OR 2.67, p=0.022), and multiple complex lesions (OR 2.66, p=0.017) were independent predictors of rapid progression of nonculprit lesions.
  
  
  CONCLUSIONS
  Enhanced inflammatory response to PCI, as well as baseline inflammatory activity as reflected by CRP level, may be involved in the progression of atherosclerosis in NSTE-ACS.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakachi
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Katsutaka
authors.initials: K
authors.lastname: Hashiba
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mitsuhashi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Endo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein